[Federal Register Volume 77, Number 155 (Friday, August 10, 2012)]
[Notices]
[Pages 47908-47910]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-19615]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions to and one extension of OMB-approved information 
collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information; its practical utility; ways to 
enhance its quality, utility, and clarity; and ways to minimize burden 
on respondents, including the use of automated collection techniques or 
other forms of information technology. Mail, email, or fax your 
comments and recommendations on the information collection(s) to the 
OMB Desk Officer and SSA Reports Clearance Director at the following 
addresses or fax numbers.

(OMB)

    Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 
202-395-6974, Email address: [email protected].

(SSA)

    Social Security Administration, DCRDP, Attn: Reports Clearance 
Director, 107 Altmeyer Building, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-966-2830, Email address: [email protected].

[[Page 47909]]

    I. The information collections below are pending at SSA. SSA will 
submit them to OMB within 60 days from the date of this notice. To be 
sure we consider your comments, we must receive them no later than 
October 9, 2012. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. When SSA needs information to determine a worker's employment 
status for the purpose of maintaining a worker's earning records, the 
agency uses Form SSA-7160-F4 to determine the existence of an employer-
employee relationship. We use the information to document the 
employment relationship; specifically, to determine whether a 
beneficiary is self-employed or an employee. The respondents are 
individuals seeking to establish their status as employees and their 
alleged employers.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                 Respondent type                    respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Individuals.....................................           8,000               1              25           3,333
Business........................................           7,200               1              25           3,000
State/Local Government..........................             800               1              25             333
                                                 ---------------------------------------------------------------
    Totals......................................          16,000  ..............  ..............           6,666
----------------------------------------------------------------------------------------------------------------

    2. Blood Donor Locator Service (BDLS)--20 CFR 401.200--0960-0501. 
The regulations on Privacy and Disclosure of Official Records and 
Information, Subpart C, stipulate that when blood donor facilities 
identify blood donations as human immunodeficiency virus (HIV)-
positive, the overseeing state agency must provide the names and Social 
Security Numbers of the affected donors to SSA's Blood Donor Locator 
Service. SSA uses this information to furnish the state agencies with 
the blood donors' address information to notify the blood donors. 
Respondents are state agencies acting on behalf of blood donor 
facilities.
    Type of Request. Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
             Regulations section                 Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
20 CFR 401.200..............................              10                5               15               13
----------------------------------------------------------------------------------------------------------------

    3. The Ticket to Work and Self-Sufficiency Program--20 CFR 411--
0960-0644. SSA's Ticket to Work (Ticket) Program transitions Social 
Security Disability Insurance (SSDI) and Supplemental Security Income 
(SSI) recipients toward independence by allowing them to receive Social 
Security payments while maintaining employment under the auspices of 
the program. SSA uses service providers, called Employment Networks 
(ENs), to supervise participant progress through the stages of Ticket 
Program participation, such as job searches and interviews, progress 
reviews, and changes in ticket status. ENs can be private for-profit 
and nonprofit organizations, as well as state vocational rehabilitation 
agencies (VRs).
    SSA and the ENs utilize the Ticket to Work Program Manager to 
operate the Ticket Program and exchange information about participants. 
For example, the ENs use the Program Manager to provide updates on 
tasks such as selecting a payment system or requesting payments for 
helping the beneficiary achieve certain work goals.
    Since the ENs are not PRA-exempt, the multiple information 
collections within the Ticket Program Manager require OMB approval, and 
we clear them under this information collection request (ICR). Most of 
the categories of information in this ICR are necessary for SSA to: (1) 
Comply with the Ticket to Work legislation; and (2) provide proper 
oversight of the program. SSA collects this information through several 
modalities, including forms, electronic exchanges, and written 
documentation. The respondents are the ENs or state VRs, as well as 
SSDI beneficiaries and blind or disabled SSI recipients working under 
the auspices of the Ticket to Work Program.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
              Collection instrument                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
(a) 20 CFR 411.140(d)(2)--Regular Telephone.....           3,214               1               5             268
(a) 20 CFR 411.140(d)(2)--Interactive Voice               12,856               1             2.5             536
 Recognition Telephone..........................
(a) 20 CFR 411.140(d)(2)--Portal................          16,071               1            1.25             335
(a) 20 CFR 411.140(d)(3); 411.325(a);                      2,370               1              15             593
 411.150(b)(3)--SSA-1365........................
(a) 20 CFR 411.140(d)(3); 411.325(a);                      2,370               1              11             434
 411.150(b)(3)--SSA-1365 Portal.................
(a) 20 CFR 411.140(d)(3); 411.325(a);                      3,913               1              60           3,913
 411.150(b)(3)--SSA-1370........................
(a) 20 CFR 411.140(d)(3); 411.325(a);                      3,912               1              45           2,934
 411.150(b)(3)--SSA-1370 Portal.................
(a) 20 CFR 411.166; 411.170(b)--Electronic File           35,584               1               5           2,965
 Submission.....................................
(b) 20 CFR 411.145; 411.325.....................           4,988               1              15           1,247
(b) 20 CFR 411.145; 411.325--Portal.............           4,988               1              11             914
(b) 20 CFR 411.535(a)(1)(iii)--Data Sharing/               8,505               1               5             709
 Portal.........................................

[[Page 47910]]

 
(c) 20 CFR 411.192(b) & (c).....................               6               1              30               3
(c) 20 CFR 411.200(b)--SSA-1375.................         112,362               1              15          28,091
(c) 20 CFR 411.200(b)--Portal...................          64,824               1              10          10,804
(c) 20 CFR 411.210(b)...........................              41               1              30              21
(d) 20 CFR 411.365; 411.505; 411.515............               5               1              10               1
(e) 20 CFR 411.325(d); 411.415..................               1               1             480               8
(f) 20 CFR 411.575--SSA-1389; SSA-1391; SSA-              14,025               1              40           9,350
 1393; SSA-1396; SSA-1398; SSA-1399.............
(f) 20 CFR 411.575--Portal......................          14,025               1              22           5,142
(f) 20 CFR 411.575--Automatic Payments..........          28,050               1               0               0
(f) 20 CFR 411.560--SSA-1401....................             100               1              20              33
(g) 20 CFR 411.325(f)...........................           1,371               1              45           1,028
(h) 20 CFR 411.435; 411.615; 411.625............               2               1             120               4
(i) 20 CFR 411.320--SSA-1394....................             105               1             7.5              13
(i) 20 CFR 411.320--SSA-1394 Portal.............             105               1             7.5              13
                                                 ---------------------------------------------------------------
    Totals......................................         333,793  ..............  ..............          69,360
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    II. SSA submitted the information collection below to OMB for 
clearance. Your comments regarding the information collection would be 
most useful if OMB and SSA receive them within 30 days from the date of 
this publication. To be sure we consider your comments, we must receive 
them no later than September 10, 2012. Individuals can obtain copies of 
the OMB clearance package by writing to [email protected].
    Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution and Request for Records 
(Medicare)--0960-0729. Under the aegis of the Medicare Modernization 
Act of 2003, Medicare beneficiaries can apply for a Medicare 
Prescription Drug Plan (Part D) program subsidy. In some cases, SSA 
will verify the details of applicants' accounts at financial 
institutions to determine if they are eligible for the subsidy. Form 
SSA-4640 provides the applicant authorization SSA needs to contact 
financial institutions about applicants' accounts. Financial 
institutions use the form to verify the information SSA requests. The 
respondents are applicants for the Medicare Part D program subsidy, and 
financial institutions where these applicants are account holders.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
               Type of respondent                   respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Medicare Part D Subsidy Applicants..............           5,000               1               1              83
Financial Institutions..........................           5,000               1               4             333
                                                 ---------------------------------------------------------------
    Totals......................................          10,000  ..............  ..............             416
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    Dated: August 7, 2012.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2012-19615 Filed 8-9-12; 8:45 am]
BILLING CODE 4191-02-P